Alivio Medical Finds Success with Peers for Progress

by HCE Exchange on January 12, 2016

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Esther Corpuz, Chief Executive Officer, Alivio Medical Center

by Pete Fernbaugh

Esther Corpuz arrived at Alivio Medical Center in Chicago, Ill., as chief executive officer nine months ago after spending the majority of her career working for Tenet Healthcare, the second largest investor-owned healthcare system in the country.

For Corpuz, transferring to Alivio was a homecoming. Having been raised in Chicago, she was familiar with the large percentage of underinsured and undocumented residents in the city, especially within the Pilsen community, which is home to one of the largest and oldest Mexican communities in Chicago.

Alivio had been struggling financially, and Corpuz wanted to make sure its presence in Pilsen would continue.

“I felt that I could really make an impact and help them get back on track where they need to be, especially with my experience coming from the healthcare investor side,” she said.

An integral presence in the region

Alivio was founded by grassroots activist Carmen Velásquez in 1989. Velásquez had no experience in healthcare and was actually trained as an educator.

But she wanted to combat the inadequate healthcare within the Pilsen community where 40 percent of the residents were uninsured, 20 percent lacked coverage beyond hospitalization, and of those who were insured, two percent had individual coverage only.

During its first year of operation, Alivio saw 5,000 patients and maintained an operating budget of $1.4 million. There was no indication then, Corpuz said, that Alivio would grow to its present strength.

In 2014, nine low-income, marginalized communities depend on Alivio as their safety-net provider. Alivio’s annual operating budget is more than $12 million, and its providers see over 20,000 Spanish-speaking, Mexican immigrants each year.

The business model upon which the Center had been founded was focused on care before finances. Because of its growth, Corpuz realized this model had become unsustainable, and the organization needed financially stability in order to remain open.

Salvaging the revenue cycle and keeping providers

From the start, Corpuz identified areas for immediate improvement. First, the revenue cycle was an ongoing struggle, especially since the organization wasn’t collecting all of its revenue on the front end. Various factors were hampering the process, including coding, credentialing, and provider and personnel issues.

“My providers work very, very hard, and they’re seeing patients who have a lot of complex issues,” she said.

Corpuz decided to outsource billing to Priority Management Group (PMG), a company that handles FQHC billing exclusively. PMG’s expertise showed immediate results.

The second area Corpuz had to address was provider recruitment and retention.

“We had a catastrophic crisis,” she said. “We lost about eight providers last fall and that really impacted our visit volumes.”

Fortunately for Alivio, Corpuz had handled provider alignment during her time at Tenet. The first step she took was to understand why the providers had left the organization.

She discovered Alivio’s financial instability was one of the reasons for their departure, and the providers were attempting to express their dissatisfaction and perception that the billing issue wasn’t being given enough attention by the leadership.

She then explored how the organization could recover from this loss through recruiting new physicians and retaining those who had not left.

On July 30, Corpuz held Alivio’s first annual provider business meeting. She labeled her discussion the State of our State Address, and she used it to brief the providers on the new billing company and present them with the 2015 Budget and with her strategy for organizational recovery.

“Not knowing and not having a plan made them nervous,” she said. “We’re trying to address the immediate concern about billing and really trying to share with them and be more transparent about our issues, including them in the plan to get us out of where we’re at.”

Peers for Progress bolsters diabetes care

Two years before Corpuz arrived, Alivio joined the Peers for Progress global healthcare initiative, which is working to improve healthcare in underserved communities. Alivio was awarded a $1.8 million grant, called My Health Comes First, through the Peers program, courtesy of biopharmaceutical company Bristol-Myers Squibb.

“We were selected because Peers for Progress wanted to do an urban program that would integrate community health workers into primary care to improve the health status of Type II diabetics,” Corpuz said.

Although community health workers had always been part of the Alivio team, they were mostly volunteers who provided the community with educational support groups. Under Peers, these workers were hired into the organization and tasked with the goal of lowering A1C-level indicators among the diabetic population, which is the gold standard for diabetes management.

Corpuz said Alivio was a late adapter of EMRs, but Peers for Progress motivated the organization to fully invest in the technology. To date, Alivio has gone live in all of its six locations.

However, the program initially failed to secure buy-in from the providers. They were reluctant to refer their patients to the health workers, and they didn’t understand how health workers with limited training could have a positive impact on their diabetic patients.

Thankfully, their concerns have been answered, Corpuz said. Under the leadership of program director Yudy Galvan, Peers patients are showing greater progress in weight loss, diet control, and physical activity than those patients who are not in the Peers program.

The team mentality promoted by Peers for Progress reflects her ultimate goals as Alivio’s leader, Corpuz said.

“I’m not Alivio by myself. It’s my responsibility to make sure that the team is all growing in the same direction and that we have a shared vision for the future. And that’s always a challenge. We have to strategically plan to work and then work the plan. It can’t sit on a shelf.

“I think you have to be incredibly focused on where you want to go in order to get there and you have to remember it’s a marathon, not a sprint. You’re not going to be able to get everything done overnight or you’ll burn yourself out.”

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